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„Home treatment“ für psychische Erkrankungen

Begriffsklärung und Wirksamkeit

Home treatment for severe mental illness

What and how effective is it?

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Zusammenfassung

In den letzten Jahren wurden vielfältige Erfahrungen mit sog. „home treatment“ (HT) für psychisch schwer beeinträchtigte Menschen gesammelt. Die Autoren erläutern und definieren HT und grenzen es von anderen gemeindenahen Behandlungsangeboten ab, berichten die vorliegende Evidenz zu HT und erörtern die Indikationsfrage. Die Literaturrecherche zur Wirksamkeit von HT bei psychisch schwer erkrankten Erwachsenen erfolgte über elektronische Datenbanken (Medline, Psychlit) und zusätzliche Handsuche. HT zeigte sich hinsichtlich der Reduktion symptomatischer Beeinträchtigung, Wiederherstellung von sozialen Kompetenzen und Patienten- und Angehörigenzufriedenheit der stationären Behandlungsoption entweder gleichwertig oder überlegen. Auch liegen die direkten Kosten für HT z. T. erheblich unter denen für eine stationäre Behandlung. Allerdings ist die Anzahl der Studien gering, und Ergebnisse zur langfristigen Wirksamkeit liegen nicht vor.

Summary

A number of projects have used home treatment (HT) for severely mentally ill people in recent years. This paper intends to define HT and show the main differences between it and other forms of psychiatric community service, present the existing evidence for HT, and discuss eligibility criteria. Studies about HT’s efficacy in treating severely mentally ill adults were identified by electronic (MEDLINE, PsycLIT) and manual search. Six studies met these inclusion criteria. Compared to inpatient treatment, HT was equally or more efficacious in respect to reduction of symptom distress, social (re-)integration, and patient and carer satisfaction. Furthermore, direct costs for HT were often lower than for inpatient care. However, the number of relevant studies is limited and knowledge on the long-term effects of HT is sparse.

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Notes

  1. Es liegen auch einige Arbeiten zur Effektivität von HT bei Kindern und Jugendlichen vor, z. B. [29], deren Ergebnisse an dieser Stelle nicht berichtet werden.

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Authors and Affiliations

  1. Abteilung Psychiatrie II, Universität Ulm

    T. Berhe,  B. Puschner, R. Kilian & T. Becker

  2. Universität Ulm, Abteilung Psychiatrie II, BKH Günzburg, Ludwig-Heilmeyer-Straße 2, 89312, Günzburg, Deutschland

    B. Puschner

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  1. T. Berhe
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Correspondence to B. Puschner.

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Berhe, T., Puschner, B., Kilian, R. et al. „Home treatment“ für psychische Erkrankungen . Nervenarzt 76, 822–831 (2005). https://doi.org/10.1007/s00115-004-1865-6

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